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Untangling the developmental relations between depression and externalizing behavior among maltreated adolescents

UNTANGLING THE DEVELOPMENTAL RELATIONS BETWEEN DEPRESSION AND EXTERNALIZING BEHAVIOR AMONG MALTREATED ADOLESCENTS
by
Matthew Brensilver
_________________________________________________________________
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(SOCIAL WORK)
August 2010
Copyright 2010 Matthew Brensilver

To study psychopathology is to study comorbidity. In both clinical and representative samples, the co-occurrence of two or more disorders is the rule, rather than the exception. While the virtual ubiquity of psychiatric comorbidity has been established, efforts have been redirected to explaining the phenomenon. The current study investigated the sources of covariation between depression and externalizing behavior among adolescent boys and girls. Specifically, it examined the plausibility that one symptom cluster exerted a causal effect on the other cluster of symptoms – a hypothesis known as pathogenic comorbidity. This hypothesis has more support among girls, and for the downstream effects of externalizing behavior on depression. A gender-balanced group of 454 young adolescents was sampled, with 303 of those having met specific criteria for the recent experience of maltreatment. The youth and their caretakers were assessed three times over the period of the next two and a half years. Pathogenic comorbidity was examined utilizing different statistical methods, each with their own unique model of change. Findings employing child and parent-report data were compared.; The preponderance of the evidence suggested that when controlling for risk factors associated with both depression and externalizing behavior, no support was marshaled for the existence of direct casual connections between the disorders in either gender. Robust within-time associations were observed, suggesting a complex relationship. Bivariate latent change score model findings were contrasted with a cross-lagged regression analyses. While the traditional model lent some support for pathogenic comorbidity among girls, the latent change score model suggested that finding was an artifact of the failure to control for nonstationarity. Results are consistent with the hypotheses that depression and externalizing behavior covary because the mechanisms of risk for one disorder are shared for the other disorder or that the phenomenological differences obscure a global psychopathological trait. Limitations of the present research and future directions are discussed.

UNTANGLING THE DEVELOPMENTAL RELATIONS BETWEEN DEPRESSION AND EXTERNALIZING BEHAVIOR AMONG MALTREATED ADOLESCENTS
by
Matthew Brensilver
_________________________________________________________________
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(SOCIAL WORK)
August 2010
Copyright 2010 Matthew Brensilver